We know orgasms can make your toes curl, but can they make your sinuses swell? Do vasectomies lower a guy's sex drive? And what is the real difference between just having sex and truly making love? Sexploration answers your queries. Got a question?
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Q: I’m a woman who has never had problems with orgasm; they come quite naturally and powerfully. [But] after nearly every orgasm my sinuses swell up and I can’t breathe through my nose for awhile. There’s no drainage; it’s just tissue inflammation and it passes as I slowly come down from my orgasm. I have my guesses — rush of blood post-orgasm; my tender, over-vasomotor-reactive sinuses (which react to changes in temps and other happenings). But why my distant-from-the-action [stuffiness] and so dramatically and suddenly?

A: You are living in Bizarro sinus world where everything works in reverse. Usually, having an orgasm clears up sinuses, at least for a little while, which is yet another in a long list of sex-as-medicinal excuses you can use. (“Honey, I’m stuffy!”) Beats chicken soup.

The reason orgasm can clear sinuses is that we get a rush of adrenaline, explained Dr. Jordan Josephson, director of the New York Nasal and Sinus Center and author of "Sinus Relief Now." The adrenaline causes tissues in the nose to shrink, opening up passageways in a much more pleasant and attractive manner than one of those goofy Breathe Right strips.

But that’s not the way it’s working for you. So what’s up? Well, suggested Josephson, “she may have a polyp that has found its way there and lodged itself” in your nasal passageways or sinuses. During sex, depending, say, on what position you get into, the polyp may fall into the path of circulating air “and that may cause an obstruction. Then, later, it gets unlodged and: "Presto! She gets better.”

Josephson explained that polyps can be caused by tissue inflammation following infection — also perhaps allergies — and then remain long after the infection has passed. They aren’t necessarily precursors to cancer, like colon polyps can be, so don’t worry too much, but to find out if you have them, see an otolaryngologist. If they can be removed, you may find you can breathe easier even when you aren’t all flushed and happy.

Q: I’m a 37-year-old remarried father of three. Three years ago I underwent a vasectomy reversal, and we’ve been actively trying to have children. However, my sex drive seems to have diminished. Is this some kind of reaction to the operation?

A: Well, maybe, but probably not in the way you think. True, the idea of scalpels around our maleness are not exactly sexy, at least for those of us not into surgical fetishes. But a reversal like yours shouldn’t do anything to desire. Reattaching the vas deferens, the little tube that carries our sperm, shouldn’t do anything physically to affect libido.

Psychologically is another story. In studies, the overwhelming majority of men who have had vasectomies say their libido goes up or stays the same. There’s no physical reason for a boost, but men may be relieved to know that sex will not result in babies who will grow up to get drivers’ licenses and apply to Middlebury College so they can study the poetry of Gerard Manley Hopkins at a cost to you of $50,000 per year. You, on the other hand, after having three kids, are now with a new wife who wants children. That means more babies and more shots at private college tuition. It’d be weird if you weren’t at least a little ambivalent. I mean, you did have a vasectomy once, right? Presumably you thought you were done spawning.

Also, you’re 37. Not old by any means, but you aren’t 20 any more, either.

Rates of women who are opting for preventive mastectomies, such as Angeline Jolie, have increased by an estimated 50 percent in recent years, experts say. But many doctors are puzzled because the operation doesn't carry a 100 percent guarantee, it's major surgery -- and women have other options, from a once-a-day pill to careful monitoring.

A: This is the sort of question that, by rights, should be discussed over glasses of Martini Bianco in a café in Paris with the smoke from a Galois cigarette, held between the thin fingers of a beautiful and challenging woman, hovering in the air like a storm cloud. But this is the Internet, alas.

It is possible to have sex and not be making love. The one-night hook-up after four mojitos comes to mind. It is also possible to make love and be having sex. Sometimes having the raunchiest, nastiest sex is a supreme act of love because when you love someone so much you can share that fantasy about your fourth grade teacher Miss Canfield, the class trip to the zoo, and the zebra incident, you’re displaying a lot of trust. And it is possible to be making love and not having sex, technically speaking, just by sharing a look, a smile, a touch.

If you want any more, you’re going to have to fly me to Paris, or at least buy me a drink.